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NO ONE KNOWS MORE ABOUT INNOVATIONS IN SKIN CARE THAN DERMATOLOGISTS. AND

MOST OF THEM CLEARLY PRACTICE WHAT THEY PREACH. (EVER SEEN A WRINKLY SKIN DOC? WE HAVEN'T EITHER.)

SO WE WENT TO THE FIVE MOST RADIANT, FINE-LINE-FREE FEMALE MDS WE KNOW AND SAID,"FESS UP." HAPPILY, THEY OBLIGED» BY MICHELE BENDER

1/They use a cleanserwith horsepower

We've all heard dermatologists en­dorse washing up with a mild, gentlecleanser. But in truth that's not what

they use at home. Most of the MDs wetalked to lather up with formulas filledwith glycolic or lactic acid (to acceler­ate exfoliation) and salicylic acid (tounclog pores and make them appearsmaller). "As an African-Americanwoman in my forties, I battle blotchi­ness. And for that, I find an exfoliat­ing cleanser is best: It evens out the toneof my skin better than a basic, no­frills formula," says Jeanine Downie,MD, coauthor of Beautiful Skin ofColor. Some doctors do use a gentlercleanser but rotate in a more aggres­sive exfoliator (a scrub or at-home mi­crodermabrasion kit) once a week toensure that no skin-dulling dead cellsare hanging around. Some favorites:Vivite Exfoliating Facial Cleanser ($39;viviteskincare.com) and the PatriciaWexler MD Microdermabrasion Sys­tem Step 1:Resurfacing Cream ($35;bathandbodyworks.com).

They fight free radicals onthe outside-and in

According to the doctors we inter­viewed, the danger of free radicals­from such sources as air pollutionand the sun's rays-isn't marketing hype,it's real. "Damage from free radicalsis one of the primary causes of fine linesand uneven tone," Downie says. Soshe and the others minimize futurewrinkles and blotchiness with anti­

oxidants, applying a serum or cream

that contains a free-radical fightersuch as vitamin C, phloretin, ideben­one, green tea or coffeeberry everymorning, after cleansing and beforeputting on sunscreen (see number3, below). Downie loves Revale SkinIntense Recovery Treatment withCoffeeBerry ($130; revaleskin.com).Other antioxidant serums to try:Elizabeth Arden Prevage Face Anti­Aging Serum ($155; elizabetharden.com, available beginning in March)with idebenone plus green tea, andSkinCeuticals phloretin CF ($150; skinceuticals.com), which contains threeantioxidants: vitamin C, phloretin andferulic acid. But most docs don't relyon topical antioxidants alone. MaryLupo, MD, a clinical professor of

. dermatology at Tulane University, inNew Orleans, also downs smoothiesmade with yogurt and antioxidant-richfruit, such as blueberries or acai. "Ibelieve skin is a mirror of your overallhealth. So I treat the inside of me as

well as I do the outside," she says.

Protection is a priority

To skin doctors, applying sunscreenis like brushing teeth: It's unfathom­able not to do it. Most apply a thinlayer as the last step of their morningskin care regimen to prevent UV ex­posure, the chief cause of prematurewrinkles and discoloration. Two for­

mulas frequently cited: For dry skin,La Roche-Posay Anthelios Daily Mois­turizer SPF 15 ($30; larocheposay.us)and, for oilier complexions, Neutro­gena Ultra Sheer Dry Touch Sun­block SPF 55 ($11; drugstores). Then,to further boost their skin's sun

shield, our experts layer on sunscreen­spiked makeup. Naila Malik, MD, acosmetic dermatologist in Southlake,Texas, sweeps on Neutrogena Min­eraI Sheers Powder Foundation SPF

20 ($13; drugstores). "It's light, safefor sensitive skin and doesn't make

me break out:' she says. Katie Rodan,MD, associate clinical professor of

dermatology at Stanford University,uses her own Rodan+Fields Mineral

Peptides SPF 20 ($29; rodanandfields.com), which absorbs excess oil.And Lupo applies L'Oreal VisibleLift Foundation SPF 17($15; drug­stores), a moisturizing liquid formulawith retinol.

4/They rave about Retin-A

Dead cells are complexion enemynumber one, say our skin experts, be­cause they clog pores and give skinan ashy appearance. So, after exfoliat­ing in the evening, most docs slatheron a retinoid cream (a topical form ofvitamin A found in Rx options suchas Retin-A and Renova, and over-the­counter in retinol), which has beenshown to speed up the rate at whichthe body sheds dead skin. But reti­noid benefits don't stop there. VitaminA also stimulates collagen produc­tion (making skin look plumper andfine lines smoother) and normalizescells exposed to UV rays, effectivelyundoing sun damage. But there's adownside: Retinoids, dermatologistssay, can be irritating if overused, somost advocate a flexible retinoid regi­men. Lupo alternates daily betweenmoisturizing Renova and the more ag­gressive (and more drying) prescrip­tion Tazorac. Downie rotates Vivite

Vibrance Therapy, which has retinol($119; viviteskincare.com), with Tri­Luma Cream, an Rx-strength retinoidthat also contains spot-fading hyd­roquinone. And every night, Rodanapplies her own Rodan+Fields Anti-AgeNight Renewing Serum ($89; rodanandfields.com), an over-the-countertreatment with retinol. Then, once aweek, she applies Tazorac as a mask for15minutes: "Tazorac is the strongest

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retinoid, but it's too irritating for meto wear all night. Using it as a maskboosts the effects of my retinol serumwithout causing flaking." Some doc­tors also apply a moisturizer under theirretinoid to dilute the strength. Orthey cut back on how often they applyit (e.g., every third night rather thanseven days a week) if they see signs ofsensitivity. (For more on what to doif your skin is irritated, check out "Ch­ch-changes: Your Skin Is SuddenlySo Sensitive;' on page 50.)

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They freeze and fillin moderation

Almost every dermatologist we spokewith says that when it comes to in­office treatments, Botox (or Dysport,its brand-new competitor) gives youthe most bang for your buck. They in­ject their foreheads to relax frownlines; a few also target their eyes' outercorners to minimize crow's-feet. Pa­tricia Wexler, MD, a cosmetic derma­tologist in New York City, says oneof her favorite new spots is along thejawline, which gives her neck a liftedappearance. For areas where deeperwrinkles have formed, most doctorssay they turn to hyaluronic acid fillerslike Juvederm or Restylane to plumpup the crevices. The most frequentlytreated spot: the nasolabial folds(aka the marionette lines beside yourmouth). Rodan and Lupo both injectthis area once or twice a year. Docs, ofcourse, get these treatments at cost;even so, they avail themselves onlythree to four times a year, which theyconsider moderate usage. You can ex­pect to pay $375 and up for one Botoxor Dysport treatment, and $600 andup for one filler treatment.

Maintaining skin bounceis essential

Yes, retinoids boost collagen and elas­tin production in the skin. But mostskin doctors don't feel that vitamin A

alone does quite enough plumping, soover this they layer a second topical con­taining either peptides or a growthfactor. Popular peptide picks: NeocutisBioRestorative Cream ($130; dermstore.com) and Olay Regenerist DailySerum ($19; drugstores). Best of thegrowth factor bunch: SkinMedica TNSEssential Serum ($250; skinmedica.com) and ReVive Moisturizing RenewalCream ($165; neimanmarcus.com).Note: Most peptide and growth factorcreams are hydrating, so you won'tneed an additional moisturizer. Like

you, these docs don't have time foran eight-step regimen. So at night theyjust cleanse, apply a retinoid cream,top it off with a collagen-boostingcream-and hit the sheets. And there

is a reason doctors typically save thebig-gun treatments like retinoids andpeptides for nighttime. "Your bodytemperature goes up while you sleep,and the heat helps products pene­trate skin better;' Rodan explains.

They sleep on their backs

Fetal-position snoozers, take note: Asurprising number of doctors believethat smashing your face into a pillowleads to permanent creases-so theytry never to do it. "Sleeping on yourface not only etches wrinkles into theskin, but fluid pools on the side of theface that's pressed against the pillow,stretching out the skin," Lupo says.Rodan went so far as to buy herself aTherapeutica Sleeping pillow ($79to $110, depending on the size; therapeuticainc.com), which is contoured to

cradle your head and neck, making iteasier to lie on your back. "The con­nection between wrinkles and how yousleep is no joke. I can look at 80 per­cent of my patients and tell you whichside they sleep on;' Rodan says.

They exercise for better skin

Most female MDs cited improved cir­culation and reduced stress as workout

benefits that help their appearance."I get stress relief from working out,which I think keeps my worries off myface," says Downie, who runs, hits theStairMaster or kickboxes seven days aweek. Malik goes to the gym for 60 to90 minutes, six or seven days a weekbecause she believes it reduces her

level of the stress hormone epineph­rine: "This hormone can cause con­

striction of blood flow and make yourskin lose its glow." Wexler swears bythe long-term effect ofPilates on skintone; Rodan, a former runner, nowgoes Spinning. "Aplastic surgeon I trusttold me to stop high-impact workoutsonce I entered my forties;' she says. "Hesaid over time it causes tiny tears inthe microscopic attachments in the skin,which can ultimately lead to sagging."~

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